Family practice notebook home about myaccount index advertisement home orthopedics book cervicobrachial disorders chapter thoracic outlet syndrome orthopedics book cervicobrachial disorders chapter neurology brachial neuritis plexus brachial plexus injury thoracic cervical rib syndrome costoclavicular syndrome hyperabduction syndrome scalenus anticus syndrome thoracic outlet syndrome examination chapter related topics adson's test costoclavicular maneuver wright's test thoracic outlet syndrome aka: thoracic outlet syndrome advertisement general neural involvement extremity pain extremity numbness arterial involvement extremity falls asleep glove distribution with or without paresis venous involvement distal extremity swelling causes costoclavicular syndrome cervical rib syndrome hyperabduction syndrome scalenus anticus syndrome overview exam: adson's test costoclavicular maneuver wright's test sensory and motor exam management: conservative (physical therapy) elevate shoulder rest on arm of chair sling pendulum shoulder exercises moist heat and ultrasound strengthening exercises for shoulder girdle muscles trapezius muscle shoulder shrug with weight serratus anterior bench press, lifting shoulders from table correct faulty posture avoid positions that exacerbate symptoms management: surgery indications vascular compromise (rare) conservative management fails after 4-6 months surgery (consider after conservative rx fails x4-6mo) removal of first dorsal and cervical ribs release of abnormal scalene muscle insertions vascular repair thoracic outlet syndrome ( c0039984 ) definition (msh) a neurovascular syndrome associated with compression of the brachial plexus; subclavian artery; and subclavian vein at the superior thoracic outlet. generic viagra shipped canada does half a viagra pill work This may result from a variety of anomalies such as a cervical rib, anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. buy viagra canada Clinical features may include pain in the shoulder and neck region which radiates into the arm, paresis or paralysis of brachial plexus innervated muscles, paresthesia, loss of sensation, reduction of arterial pulses in the affected extremity, ischemia, and edema. cheap viagra online (adams et al. viagra pills , principles of neurology, 6th ed, pp214-5). generic viagra without prescription Definition (nci) a syndrome resulting from the compression of the blood vessels or nerves in the space between the clavicle and first rib (thoracic outlet). what does viagra 100 mg do It is caused by car accident injuries or repetitive job or sport-related injuries. viagra 30 mg Signs and symptoms include pain in the shoulders and neck, numbness in the fingers, and weakening grip. best price viagra us Definition (medlineplus) if you have thoracic outlet syndrome (tos), the. order viagra buy viagra canada